Embed Size (px)
Citation preview
2 Employment details (The person completing this section must be the candidate's present employer.)
Employment status: Employed Self-Employed Unemployed
This section may be left blank if you are currently unemployed.
Company name: Current employment position:
Address:
Postcode/zip code:
I certify that to the best of my knowledge and belief the particulars given by the applicant are correct insofar as they relate to professional education and/or training.
Name (in block capitals): Position:
Signature: Date:
Institution membership number (if applicable):
Form G: Application for admission/transfer to Graduate membership
Regulations for Graduate MembershipBefore completing this application form applicants must have read the regulations governing admission or transfer to Graduate Membership: these can be found at www.istructe.org.
1 Candidate’s personal details (to be completed in block letters)
Surname/family name: Title: Mr/Dr/Mrs/Miss/Ms/other:
Forenames/other names: Date of birth:
Previous surname (please provide proof):
Full communication address: Telephone number (work):
Telephone number (home):
Telephone number (mobile):
Nationality:
Postcode/zip code: Student Membership number (if known):
E-mail (home): E-mail (work):
International HQ47–58 Bastwick StreetLondon, EC1V 3PSUnited Kingdom
tel: + 44 (0)20 7235 [email protected]
3 vided). Please also include completion of any individual university-based modules. Please complete this section even if already a Student Member.
Name of academic institution eg. University of London: Full name of course including relevant discipline and grade achieved, indicating full or part time. E.g: MEng Civil Engineering (full time):
Date of commencemente.g. 01/09/04:
Date of completion e.g. 01/07/08:
CEng CEng with F/L IEng
The Institution of Structural Engineers may also provide copies of the documents containing these false details to these other interested parties.
application of the reason why my application has been rejected.
Signature: Date:
5
Chartered Membership (equivalent to accredited 4 year MEng)*
Associate-Membership (equivalent to accredited 3 year ordinary degree)*
* Please tick against the grade for which you wish to be assessed and ensure that full details of the course content and/or academic record accompany the application. Please ensure appropriate assessment fee is attached.
4 Membership and grade of other professional bodies eg. ICE, HKIE, etc.
Please state:
7 Disability declaration
I wish to inform the Institution of a disability:
Disability: Signature:
Date:
6 Supporting documentation checklist
Have you included:
Proof of change of name (if applicable)
The appropriate subscription fee (refer to our website: www.istructe.org). Payments can be made by cheque or bankers draft made payable to The Institution of Structural Engineers or by completing the enclosed form. Card types accepted are Visa, Master Card, Switch, Maestro Delta and Solo cards.
Candidates whose courses are not accredited with the Institution need to additionally submit the following:(If you are unsure whether this applies to you please contact the membership department: [email protected])
Academic assessment fee (refer to our website: www.istructe.org)
Ask
8 Candidate’s declaration and undertaking
This form of undertaking is to be completed by any candidate for admission or transfer to any class of membership of the Institution other than Honorary Fellow in accordance with the provisions of bye-law 1.13.1.
I have read the charter, the bye-laws and the code of conduct. Whilst I am a member I undertake to be governed by the laws of the Institution for the time being
the objects of the Institution; to attend Institution meetings as often as I conveniently can, and to endeavour to present to the Institution an original communication relating to structural engineering. I further undertake that, upon the cessation of my membership, I will cease to describe myself in any way as a member of The Institution of Structural Engineers. I have no criminal conviction unspent within the relevant jurisdiction. I am not subject to a bankruptcy order, restriction or
agree to the Institution processing data relating to my membership and (where necessary) transferring such data outside the United Kingdom.
Signature: Date:
Disclaimer: The information you provide on this form is required to enable The Institution of Structural Engineers and its Regional Groups to communicate relevant information/services to its members. Once you have been elected, you have the facility to amend your contact details and preferences via the ‘my account’ section on the website.
Please return by
post only to: The
Institution of
Structural Engineers
International HQ
47–58 Bastwick Street
London, EC1V 3PS
United Kingdom
tel: + 44 (0)20 7235 4535
www.istructe.org
Credit/debit card authorisation form* *If you are emailing your application to the Institution or wish to make payment online, please do not include your card details. We will contact you once your application has been processed to request payment or provide you with further instructions on how to pay online.
I,
hereby authorise The Institution of Structural Engineers to debit my credit/debit card to the value of £
Card type e.g. VISA/MasterCard: Expiry Date:
Card Number: Issue number (if applicable):
Start date (if applicable): Security Code (last 3 digits on the signature strip):
Please tick the box if you require a receipt for payment
Signature: Date:
For office use only:
Membership no:
Payment for: Annual subscription Application fee Engineering Council fee PRI fee
ICP(AQP) fee Technical report (A) Technical report (B) Late fee
Exam fee Other
